Bone regrowth

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After a shoulder has collasped is it still possable for new bone to form? If there can be no new growth and the shoulder is not replaced is there any more damage that can happen or does the death of the joint stop there? I do not wont surgery but, I also do not what to make it worse for me down the road. Thanks Nancy

-- Nancy Lombardi (nanlombardi@aol.com), July 31, 2003

Answers

It is hard to give specific advice without seeing the x-rays, but hear are some generic comments about AVN of the shoulder, that actually apply to AVN of all joints. In the beginning the surface of the joint is not affected. What is affected is the bone that supports the surface of the joint. When the bone dies, it is not realy any different from the bone that is alive. It is just as strong. However, when living bone is stressed in the common activities of everyday life, microfractures occur which are rapidly repaired by the living bone but not by the dead bone. Given time, this microfractures accumulate to become macro fractures, this is fractures that can be seen on x-rays, and then the bone starts to collapse. Once the collapse starts, there is no going back. This is often when the pain starts. Initially, the collapse is only on one side of the joint, for the shoulder, the humneral head (that part of the joint that is attached to the top of the upper arm). However, when the joint collapses, it is no longer round and smooth and everntually the other side of the joint is affected. If the collapse is treated early it is possible that only one side of the joint would have to be replaced. In the case of the shoulder that is a much smaller, and more successful operation than replacing both sides of the joint. Hope all this helps in your understanding.

-- David Hungerford (dhunger@jhmi.edu), August 06, 2003.

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